Bewick Crescent Surgery

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We carried out an announced assessment of one quality statement, equity of access, under the key question responsive and found: The leaders used peoples feedback and other evidence to actively seek and improve access for people. Services were designed to make them accessible and timely for people including those most likely to have difficulty accessing care. The provider prioritised, allocated resources and developed opportunities as needed to meet patient’s needs and achieve equity of access. Improvements were needed to patient satisfaction with accessing the service by telephone, appointment times and experience of making an appointment. The practice had taken steps to address this and recent feedback from other sources showed satisfaction had improved.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Person-centred Care during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Providing Information during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Listening to and involving people during this assessment. The score for this quality statement is based on the previous rating for Responsive.

In the 2023 National GP Patient Survey, the practice’s data demonstrated that patient satisfaction with the appointment they were offered was 75%, which was above the national average of 72%. Patient satisfaction with appointment times was 46% which was below the national average of 53%. Patient satisfaction with making an appointment was 45% which was below the national average of 54%. Satisfaction with getting through to the practice by telephone was 29% which was significantly below the national average of 50%. Results from the NHS Friends and Family Test (FFT) were reviewed. This showed that from November 2023 to January 2024 there were a total of 139 responses received and 114 (82%) rated the practice as very good or good. The provider had undertaken their own patient survey in November 2023 and 236 patients had responded. Patients were asked to score the service from 1-10 with 1 being very poor and 10 being excellent. Results indicated 82% of patients gave a score of 5 or above regarding how easy it was to schedule an appointment. 92% of patients gave a score of 5 or above for waiting times for an appointment and overall experience of the service. Where any aspects of survey results were lower than expected the practice analysed these and made changes to improve. The provider worked with the Patient Participation Group (PPG) to seek feedback on a range of issues including access. We received feedback from 19 patients. Overall, comments were positive. Sixteen comments were positive and included information to indicate good access, 3 comments were negative and included information about it being difficult access appointments. We found the leaders had gathered feedback, responded to it and were continuously making improvements.

The leaders were aware of the challenges to patient access and had acted to make improvements. They had introduced a full triage process over two years ago and told us how this had improved patient access. The practice created action plans in response to patient surveys and other feedback. We were told how these changes were assessed to make sure patients were not disadvantaged and how the impact of the changes was being monitored. Following the 2023 National GP Patient Survey the changes introduced included a new telephone system, increased staff to answer phones and improved availability and choice of appointments. The leaders also told us about other ways they had improved access in the last 6-12 months. For example, evening clinics were available for patients to access services such as cervical screening and menopause advice, a walk-in flu and Covid 19 vaccination clinic were provided and there was improved access to immunisations for children. Leaders told us about the ways that the practice was working with other local stakeholders to improve access to primary care, such as their work with the PCN to provide a paediatric clinic every morning. The leaders explained how they provided opportunities and support for different groups of the patient population to overcome health inequalities. This included adjustments to the registration process and to how patients communicated with the practice. People in vulnerable circumstances were easily able to register with the practice, including those with no fixed abode such as homeless people, asylum seekers and refugees and Travellers. The practice was a designated Safe Surgery (following NHS guidance to help ensure everyone in their community can access healthcare they are entitled to). It was clear that improving access and patient experience was a priority. Leaders reviewed data and feedback and changes were made to ensure improvements would have a positive impact for their patients.

The service provided a total triage system whereby, the majority of requests for appointments were triaged by a GP following a patient contacting the practice by electronic form, telephone or in-person. The GP directed the patient to an appropriate clinician and appointment type to meet their needs, prioritise any urgency and utilise appropriate resources. Appointments could be face to face, over the telephone or home visit. Appointments were offered same day or in advance. Some appointments were pre-bookable. A dedicated clinical team were in place to provide home visits. The leaders told us how the triage system had improved patient access. There were monitoring arrangements for the process for booking appointments to ensure it was effective and for the telephone system to ensure response rates were meeting patient needs. Systems were also in place to monitor demand and capacity to help determine the required number of appointments and staffing levels. Information regarding access was displayed at the practice, online and by telephone message. Arrangements were in place for addressing communication barriers with regards to information. Staff were trained, competency checked and were supported by documented protocols to book appointments with members of the practice clinical team or signpost patients to other appropriate services. The practice offered appointments with a variety of clinical and non-clinical staff for example GPs, health care assistants, advanced nurse practitioners, pharmacists, practice nurses, physiotherapist, health and wellbeing coaches and social prescribers. Appointments were available at the practice from 8.30am to 5.30pm during weekdays except for Tuesdays when extended hours appointments until 7.30pm were available. The branch practice was open from 9am to 11.30am Monday and Friday and from 3.30pm to 5.30pm Monday to Friday. Further access was available to patients evenings and weekends as part of a service provided by the PCN.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.